| Sumario: | Background: Generalized anxiety disorder (GAD) is one of the most common childhood psychiatric disorders that continues into adulthood if untreated. Despite the high prevalence of these disorders, they are not diagnosed and treated correctly in 80% of cases. Objectives: This study compares the effect of internet-based cognitive behavioral therapy (ICBT) and art therapy with the drawing approach on GAD in children. Methods: This randomized clinical trial was conducted on children aged 8 to 10 with GAD referred to the Educational Clinic of Mazandaran University of Medical Sciences in 2022. The participants were selected from eligible children on the waiting list. The evaluation was done with Kiddie schedule for affective disorders and schizophrenia-present and lifetime version, strength and difficulties questionnaire, and Spence children's anxiety scale. The block randomization method allocated the participants into three groups of 15 children. The first group received eight sessions of art therapy. The second group received eight sessions of ICBT. The third group (control) received only supportive services. The evaluations were done before the first session, immediately after the end of the intervention, and two months later (follow-up). Data analysis was performed using the SPSS software, version 20. Results: There were no statistically significant differences between the three groups regarding demographic and essential variables at the beginning of the study. Repeated measures analysis of variance showed that in the ICBT group, the mean anxiety score immediately after the intervention and at the follow-up time had a significant decrease compared to before the intervention (P=0.0009). The art therapy group obtained the same results (P=0.0009). The mean anxiety score changes during the study in the ICBT group were higher than the control group (P<0.000). The mean changes in anxiety score in the ICBT group were also higher compared to the art therapy group (P=0.0003). There was no significant difference between the art therapy group and the control group in terms of changes in anxiety scores (P=0.322). Conclusions: ICBT is more effective compared to art therapy in reducing the anxiety scores of children with GAD.
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